When It Comes to Pain, Doctors Sometimes Fail

    

 

Yes, PAIN and PATIENTS is a controversial subject. Arguments abound…too much pain medication and the patient is OUT OF IT. Not enough and the patient is suffering. Who decides? Often a patient has a medication pump that he or she can use to increase the dose. But of course, there are always guidelines depending on the drug being dispensed, the patient’s weight, the disease they are suffering from, and other factors.

But what if we are talking about eventual death…in the Chicago Tribune, a recent Letter to the Editor carried me back to my friend Sue. Diagnosis, ovarian cancer. Her response: more strength than one can ever imagine. Her education and career: nursing. After the diagnosis and the minor medical attempts to save her life, Sue even kept on working for a while. Then the pain. Then she was home. And what was she reading when I would visit her?

The Emperor of All Maladies by Siddhartha Mukherjee, the author being the winner of the Pulitzer Prize, his work presented in a documentary by Ken Burns on PBS. Yes, of course Sue would be reading about cancer. As a medical professional, she wanted to know what was taking her life; she wanted to understand the epic battle of the twentieth century to cure, control, and conquer CANCER and its essence…now her personal battle.

A blurb about the books states: The story of cancer is a story of human ingenuity, resilience, and perseverance, but also of hubris, paternalism, and misperception. The author, Mukherjee, recounts centuries of discoveries, setbacks, victories, and deaths, told through the eyes of his predecessors and peers, training their wits against an infinitely resourceful adversary that, just three decades ago, was thought to be easily vanquished in an all-out “war against cancer.” The book: a literary thriller with cancer as the protagonist. 

THE WAR ON CANCER

My husband has a form of leukemia and has battled it for years. A new therapy saved his life in a clinical trial. His tenacity and desire to live is part of winning that battle. Sue had tenacity too. But her foe was one of the worst diagnosis a woman can get. And that brings me to the Letter to the Editor in the Chicago Tribune, written by Michael, whose mother had ovarian cancer, same disease as Sue, her case advancing exactly like Sue’s: five years of vigorous treatment; then the waiting: intestinal blockages, inability to eat and such agonizing pain that “no amount of pain medication or palliative care…can assuage that level of suffering.”

I was at Sue’s bedside a day before she died…agonizing pain, suffering. Mukherjee is asking if there is a better way for doctors to help these patients, he insisting, as I do, that modern medicine is not addressing the terrific suffering these patients endure. And the writer is angry at Dr. Errol Baptist for taking the position that “assisted suicide is a final solution to the problem of pain that doesn’t exist.”  

The gentleman who wrote the letter will always be angry and saddened that his mother had to suffer so much, and that those extra days with him were no benefit to her…”There must be a better way, Doctor,” he writes. He also wonders how any doctor can stand at the bedside of suffering and know that the pain is not only physical, but one of despair.  

As I write this, I know that many doctors would agree with the writer. But there is one thing about being human that we don’t understand: standing at the bedside is miles, so many miles away from the person in the bed. We, visitors, doctors, nurses eventually walk away. The patient waits. Pain remains. So, what can we do about it? Thanks for reading. 

6 Responses

  1. Very thought prevoking .. I think unfortunately the government has stepped in to manage doctors ability to manage pain.
    This IMO started a few years back when pain med docs became so prevalent…. Their thinking was no one should ever experience any pain .. this is only my opinion, Beth.
    So many people became addicted to pain meds and it snowballed into a crisis. The government felt it was their job to step in.
    I’m not judging either side of the fence.
    I just saw big changes in prescription writing due to government intervention … I don’t pretend to be an expert on this … just my humble observations

    1. Hi Karen,
      Thanks, I do remember when living in Iowa that PAIN CLINICS were becoming a thing. Sue was diagnosed around 2010, if I am remembering correctly. She was funny and amazing, talking as the disease progressed that she now had two assholes. As a nurse, she knew the drill and never complained. But when she way dying…I wept, praying she would go soon.

      I so appreciate you reading and commenting, Beth

  2. After the chronic pain I had when my hip failed (which was nothing compared to your friend’s pain) I have some understanding of what it’s like to not be able to access pain management in any form other than mild headache pills. It seems we’ve gone from too much medication being freely available to virtually nothing for those who suffer. Addiction is very real – but so is pain, and for those at the end stage of life, addiction isn’t an issue – doctors should be able to prescribe for them what they need to be able to manage the last moments of their life with some form of ease. Balance is the key – and I’m so sorry for Sue’s passing.

    1. I totally agree, Leanne, and I THANK YOU SO MUCH, for reading and for your comment. I feel we need to be prepared for things that we might never have to deal with. But when the time arrives, how do we help a loved one or even ourselves.

  3. This brought me back to 1974 and watching my once robust, full of life aunt die from pancreatic cancer. No one should have to suffer like your friend, or my aunt,did. Whatever they gave her in 1974 for pain (and she died in the hospital so perhaps it was morphine) didn’t even begin to touch the pain of her final weeks. I agree with Leanne 1000%. Addiction shouldn’t be an issue when the terminal nature of the illness is obvious.

    1. Thanks for writing, Alana. This is a story that keeps repeating itself…the diagnosis of this particular disease and the pain. It makes me angry. It makes me wonder…is it women who are not being heard???

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